Abstract
Objective
Our objective was to evaluate the outcomes of the hypertensive and preeclamptic pregnancies with or without fetal growth restriction (FGR).
Methods
We retrospectively studied 437 hypertensive pregnant women treated by calcium antagonists and divided in four groups: Gestational hypertension (GH) with or without FGR (GH-AGA: 244; GH-FGR: 78) and preeclampsia (PE) with or without FGR (PE-AGA: 76; PE-FGR: 39). Outcomes considered were: the need for a second-line treatment, prolongation of the pregnancy after diagnosis, duration of treatment in puerperium, gestational age at delivery, neonatal birth weight, perinatal mortality and neonatal malformations.
Results
A second line treatment was added in: GH-AGA: 15.4% vs. GH-FGR: 32.8%; PE-AGA: 28% vs. PE-FGR: 50%. We found a significant difference in delivery delay after diagnosis (31.3±5.4 vs. 20.7±3.4 days and 35.3±4.5 vs. 22.2±3.1; p<0.001). Gestational age at delivery was (p<0.001): 35.5±2.3 vs. 35.6±2.5 and 34.4±1.7 vs. 33.1±2.3. A significant difference in birth weight was (p<0.001): 2,271±759.1 vs. 1,817.59±396.9 and 2,196±685.17 vs. 1,465.80±441.7. Mortality was 2.56% (2 cases) for GH-FGR and 10.2% (4 cases) for PE-FGR. No neonates showed malformations.
Conclusions
Gestational hypertension and preeclampsia increase the risk of low birth weight, on the other hand the fetal growth restriction is a determinant factor for the outcome of hypertensive and preeclamptic pregnancy, perinatal morbidity and mortality of the fetus and for the management and treatment efficacy of the mother.
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References
HMSO (1994) Report on confidential enquiries into maternal deaths in the U.K. 1988–1990. Department of Health, London
Long PA, Abell DA, Beischer NA (1980) Fetal growth retardation and pre-eclampsia. Br J Obstet Gynaecol 87:13–18
Roberts JM (1998) Endothelial dysfunction in preeclampsia. Semin Reprod Endocrinol 16:5–15
American College of Obstetricians and Gynecologists (2002) Hypertension in pregnancy. ACOG Practice Bulletin no. 33 January
Braner WE, Edelman DA, Hendricks CH (1976) A standard of fetal growth for the United States of America. Am J Obstet Gynecol 126:555–564
Tranquilli AL, Romanini C (1999) Calcium antagonists in the treatment of hypertension in pregnancy. Parthenon, New York
Churchill D, Perry IJ, Beevers DG (1997) Ambulatory blood pressure in pregnancy and fetal growth. Lancet 349:7–10
Gerretsen G, Huisjes HJ, Elema JD (1981) Morphological changes of the spiral arteries in the placental bed in relation to pre-eclampsia and fetal growth retardation. Br J Obstet Gynaecol 88:876–881
Von Dadelszen, Ornstein MP, Bull SB, Logan AG, Koren G, Magee LA (2000) Fall in mean arterial pressure and fetal growth restriction in pregnancy hypertension: a meta-analysis. Lancet 355:9198
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Tranquilli, A.L., Giannubilo, S.R. The "weight" of fetal growth restriction in 437 hypertensive pregnancies. Arch Gynecol Obstet 270, 214–216 (2004). https://doi.org/10.1007/s00404-003-0540-7
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DOI: https://doi.org/10.1007/s00404-003-0540-7